NPI Profile for HOMETOWN FAMILY MEDICAL CLINIC LLC in PALESTINE, AR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1962024018 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/12/2020 | |
| Last updated | 09/09/2020 - About 6 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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